Shoulder injuries can be of different types, including when your AC joint is affected. This is how you take care of it
It is common for people to injure their shoulders while playing a contact sport or while working out. We speqk to experts to tell you how to identify the type of injury you have and how to rehab for an AC joint injury
Most mobility exercises and resistance training is done to strengthen the muscles of the upper back and shoulders. The big benefit of these is to prevent sprains, pulls and inflammations. Meanwhile, exercises done for the rotator cuffs and the scapula and deltoids help prevent injuries that can happen while lifting or due to bad form. However, it is also important to know what it feels like when there is an impact injury in the shoulder area. This is common for those who play contact sports like football or practice forms of mixed martial arts and boxing, but can also happen due to falls or running into something by accident.
In most of these cases, the point of contact usually occurs on the top of the shoulders, and this can lead to an injury in the AC joint (acromioclavicular joint).
The area is easy to spot—the AC joint is located at the highest point of the shoulder, acting as a connector between the shoulder blade and the collarbone. So just trace your collarbone laterally until you reach the top of the shoulder where you feel a capsule-like area protecting this joint.
With more people lifting weights and doing various forms of exercise than ever before, awareness about rotator cuff injuries has grown, but as this observation from Physiopedia tells you, there needs to be better understanding about the AC joint, and its connection to the muscles around it.
“The AC ligament controls horizontal stability in the anteriorposterior plane whilst the coracoclavicular (CC) ligaments serve to control vertical stability. The conoid part of this ligament attaches posteriorly and medially on the clavicle… The trapezius and deltoid muscles also provide dynamic stabilisation of the AC joint," states the article titled, Acromioclavicular Joint Disorders.
It also adds that most AC joint injuries happen when “falling onto an outstretched hand or elbow, direct blows to the shoulder, or falling onto the point of the shoulder."
I suffered what Ithought was an AC joint injury last month but there are ways to know whether it was that or rotatorcuff trauma. "Usually AC joint pain is very localised and the tenderness can be felt on the tip of the shoulder. Movement of the arm away from the body might feel like relief whereas in a rotator cuff injury, the pain is felt in the entire deltoid region and is not limited to a particular point. This pain will get provoked whether you move your arm in front of you or to the sides and will increase at night," says head physiotherapist at Bengaluru Football Club Naved Hameed. Given that my pain travelled to different points on differentdays is a clear indicator that the rotator cuff was aggrieved.
Hameed adds that because of the lack of movement due to pain in the initial stages, shoulder injuries such as these can be hard to diagnose. So it's clever to strengthen all areas rather than keep targeting only one part of thejoint. This means more robust physiotherapy and rehabilitation and going beyond the usual band tears and Y-T-Ws, both of which I still continue to do but in more intense ways.
Take for example a band tear, done for scapular retraction, where you take a longer resistance band and pull it apart. A more intense version of this would be using the cable crossover machine. Face the cables and hold both sides with the hands and pull them in a manner they criss-cross and the hands travel back, making sure your scapulas are taking the load. I wrote a detailed piece on why the scapula is important to strengthen in a Lounge piece titled Why you need to do these exercises for your shoulders, in which there are easier exercises listed down.
You may find that pushing exercises are particularly tough to do when the AC joint is irritated. The last part of extending the arm and elbow during an overhead press is almost impossible and the irritation can be felt while doing bench presses as well.
Which means there is a higher reliance on pulling exercises to make this better. This is where using your main lifts as your rehab lifts can be useful. Find a mid-back row machine and use lighter weights to slowly do mid-back rows making sure the thoracic spine is extended. Some trainers may suggest leaning forward to add more load to the mid-back during these rows, but that is for size and strength. For repair work, stick to the basics.
There are two more exercises that are advanced but extremely useful to avoid a recurring injury. The first is to attach a long resistance band with minimal resistance to a point slightly higher than shoulder height, and standing next to it with one arm extended as if doing a lateral raise. Wedge the hand in the band and pull it towards the side of your body. Almost like a reverse lateral raise. This exercise has some pushing involved, but not in unfriendly angles for the AC joint.
And then there’s the banded angel, as shown in the video above. This is where you stand and pull two ends or resistance up and away from each other. It might not be easy to find equipment for this, but the prone swimmer is another option, which can be progressed into the same exercise done on a bench with light weights.
The thing to remember is that not all shoulder injuries have the same recovery exercises. The most complicated joint in the body sometimes needs more, and that means progressing with your rehabilitation work as much as you do with your gains.
Pulasta Dhar is a football commentator and writer.
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